PICA SYNDROME: A HIDDEN ETIOLOGY OF FRQUENT BRACKET DEBONDING – CASE REPORT

Mouthing syndrome is typically defined as the persistent eating of non-nutritive substances like metal pieces such as coins, wire needles. These habits were seems to be hidden and undiagnosed, because usually patient doesn’t give history of eating of non nutritive substances. This disorder is found among the group of south East Asian ethnic group in particular females. Case presentations 17 year young female patient came with a complaint of forward place upper teeth and wanted to get treated. On thorough clinical examinations all the first molars had sever occlusal wear and deepened occlusal fossae also clinical crown height reduced. Study Model analysis and cephalometric analysis reveals that bimaxillary dentoalveolar protrusion with excessive gummy smile. Premaxillay setback was the treatment objective. Case was started with fixed appliance 0.022 inch slot brackets (Roath prescription) were placed in both mandibular and maxillary arches. Patient was recalled for first regular / routine check up , on examination molar bands were chewed badly and complete posterior segment brackets were damaged. However on neat examining notches were deepen. Repair done and instructions were given visit after two week. On examining after two week only molar bands were squeezed. Consecutively visit days were reduced to weekly, still band were found chewed. Patient was referred to family physician for consent. Physician reported as patient suffering from pica syndrome. Conclusion Most commonly mouthing disorder occurs due to mineral deficiency and psychological disturbances. In Asian countries females are likely to take orthodontic treatment more as compared to males. Standard literature shows 20-28% young female with Asian (muslim) ethenic group show mouthing disorder. Also 8.1% female during pregnancy due to scarcity of minerals